FDA Adverse Event Malfunction Summary report: N

ALENTI

MDR report key: 3221147 · Received July 5, 2013

Report

Report Number
9611530-2013-00074
Event Type
Malfunction
Date Received
July 5, 2013
Manufacturer
ARJO HOSPITAL EQUIPMENT AB
Product Code
FSA
Report Source
Manufacturer report

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT IS BEING FILED UNDER EXEMPTION (B)(4) BY ARJOHUNTLEIGH (B)(4) ON BEHALF OF THE IMPORTER (B)(4). PLEASE NOTE THAT ONLY AS RECENT AS (B)(6) 2013, WE HAVE RECEIVED OUR FIRST CLEAR INDICATION BY A CUSTOMER THAT ALLOWED US TO IDENTIFY THERE TO BE AN ISSUE AND POSSIBLE MALFUNCTION OF THIS BELT THAT MAY LEAD TO CAUSE SERIOUS INJURY OR DEATH SHOULD THE USER NOT OBSERVE INDICATIONS IN THE DEVICE LABELING: TO HAVE THE PERSON ON THE DEVICE IN THE CENTER OF THE CHAIR AND EVALUATE THEM BEFORE USE. SUBSEQUENTLY, WE HAVE STARTED PERFORMING SIMULATIONS THAT SHOWS THERE MAY BE A RISK. THEREFORE, WE HAVE NOW DECIDED TO REPORT HENCEFORTH COMPLAINTS WHERE IT IS INDICATED THE BELT BUCKLE WAS NOT CORRECTLY FUNCTIONING. THIS MEANS THAT WE REPORT THIS COMPLAINT WITH AN ORIGINAL AWARENESS DATE OF MORE THAN 30 DAYS BEFORE TODAY. ADDITIONAL INFORMATION WILL BE PROVIDED FOLLOWING THE CONCLUSION OF THE MFR'S INVESTIGATION.

Description of Event or Problem · 1

REF IMP REPORT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
307497 ALENTI FSA ARJO HOSPITAL EQUIPMENT AB

Patients

Seq Age Sex Outcome Treatment
1